A therapist's take on life, the world, you and me.

It’s only chemical

Good question. Why talk to a therapist if you can take a pill and be done with it?

Freud was intrigued by the possibility. According to Peter Gay, in Freud’s late work, “Outline of Psychoanalysis:”

“[he] speculated that the time might come when chemical substances would alter balances in the mind and thus make psychoanalytic therapy, now the best available treatment for neuroses, quite obsolete.”

It’s appealing to treat mental illness as a chemical problem because chemistry seems clean and precise. The fundamental functioning of the brain is both chemical and electrical, based on the difference in potentiality between sodium and potassium. No problem. You identify an imbalance, add ingredients, stir, and restore order.

But there is a problem. The brain is also a ball of flesh, soaking in countless compounds we scarcely comprehend.

Injecting a drug – one more chemical – into your bloodstream is a primitive way to fine-tune complex chemistry.

That’s why psychiatric drugs are most effective when blunt, simple results are called for. They can slow you down. They can speed you up. They can numb you or narrow your emotional bandwidth. If you are bi-polar, they may help stabilize your emotional swings. If you are psychotic, they may bring you back to reality, or at least closer to it.

How could talking in a therapist’s office affect the chemistry of the brain?

Your emotions are chemicals. When you feel angry, your amygdala, a region in the center of your brain, releases a chemical signal. That chemical – or series of chemicals, is what you experience as “anger.” Joy, fear, sadness – all the emotions you feel as fundamental responses to the world around you – are chemicals.

Your thoughts are also chemicals. When you admire a sunset, you are releasing chemicals which trigger electrical impulses that race through the circuitry of your brain.

Your thoughts affect your emotions. So if I can affect your thoughts, I can affect the chemicals triggering your feelings.

The brain is extremely mutable – neural pathways can be rerouted. If I can make you aware of your thoughts and feelings, I can reroute the neurons in your brain, so different chemicals are released.

This isn’t as far-fetched as it sounds. Here’s an example: If you are depressed and I tell you to go for a run because it will cheer you up, I’m not merely nagging. Aerobic exercise releases endorphins in your brain. These chemicals cheer you up, relieving depression.

In the process, you will also create a memory – a piece of stored chemical information – that links depression with going for a run and feeling better. A faint, newly formed neural link, and a piece of memory supporting that link, have been created.

Here’s another example: if you are denying your anger – the typical pattern that creates depression – and I arrange during a session of psychotherapy for you to address your father, or your mother, or your boss or your girlfriend, and you feel anger well up and put that anger into words, saying what you’ve kept silent for years…that’s going to have effects on the chemistry of your brain.

When you get the words out, and feel your buried anger, new pathways will form between the ancient regions governing emotion in the center of the brain and more recently evolved cognition areas in the outer cortex.

New thoughts circulate new chemicals, create new memories, and effectively rewire the way you think.

You leave my office realizing you were angrier than you thought, and knowing it felt good to get it out. You experience a lightening of mood. Your girlfriend, when you get home, senses that you are less defended – your resistances are down. This alters her behavior towards you, and she starts to open up to you emotionally to a new degree. You begin questioning your old responses to her, and your old ways of doing things in general.

Your brain is flooded with new chemicals, and new pathways have been formed, that might, with further talk therapy, begin to replace old ones.

Subtle changes have been made to the chemistry of your brain – to who you are, how you think, and how you behave with others.

That’s what psychotherapy is all about:

Better living through chemistry.

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5 Responses

This has nothing to do with the “chemistry” post (which I found interesting), but this article is a must-read for prospective and current law students, and picks up on what Will has been saying for months:

To treat my depression, my doctors employed both medication (Lexapro) and talk therapy. The combination has been and continues to be invaluable. The Lexapro truly helped me attain a measure of equilibrium and, importantly, rest; within five weeks of starting it, I was sleeping normally again after months of horrible insomnia, and I was far less prone to panic. But the medication on its own doesn’t *teach* you much — what your triggers are, for example. The therapy does that, and it is a supreme benefit. Both approaches helped keep me alive and recovering, not just one or the other.

[…] taken to using day-dreaming, well, attempting to use it, as part of my anti-depression toolbox. Happy thoughts set off chemical reactions, blah, blah, blah, which blah, blah, making me feel better, or at least […]

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Will Meyerhofer, JD LCSW-R is a psychotherapist in private practice in TriBeCa, in New York City.
You can visit his private practice website at: www.aquietroom.com.
Will holds degrees from Harvard, NYU School of Law and The Hunter College School of Social Work, and used to be an associate at Sullivan & Cromwell before things changed...
Now, in addition to his work as a psychotherapy, he writes books and blog entries and a column for AboveTheLaw.com.